The common cold
For weeks now, Wes has been struggling with a cold. Sniffles, congestion, and a recurrent cough have ebbed and flowed since the new year, though a few weeks ago he was still well enough to undergo his monthly lumbar puncture and intrathecal chemo.
Two weekends ago it progressed enough that we began to be seriously concerned, and by that Monday he was feverish and had to make a trip to the ER. They did the usual – ran a CBC, started cultures, and administered a strong antibiotic – and, in part thanks to every bed in oncology being occupied, sent him home to recover. While this was a routine ER visit for him, it was unusually difficult – it took three painful attempts to access him when he arrived, leaving everyone in the room sobbing. When he was finally discharged and sent home, the nurse made an unfortunate mistake and forgot the heplock before de-accessing him. Thankfully, this was caught before they left or it could have been dangerous, but it meant having to re-access him just to de-access him. Four accesses in a single visit. Not fun.
By Wednesday, two days later, we could no longer fight the fever back and he had to go back in. Being a weekday, he was able to be seen by his oncology team at our clinic, instead of ER at the main hospital, gambling that he would not have to be admitted – an admission from clinic means an ambulance ride, never fun. The resolution by his oncologist was the same – go home, lots of fluids, rest, and minimal use of Tylenol to control the fever unless it got severe.
Once again, little over a day passed before it was clear his fever wasn’t going to fully cooperate, hovering just around the threshold where he’d have to be seen again. A week of nonstop monitoring was already exhausting, but was also beginning to be demoralizing. An admission seemed assured – we’d avoided it for so long, but had seen no progress towards his recovery, and by this point we were all showing symptoms of the same bug.
Friday he was seen again at clinic and since nothing had shown in his CBC, cultures, or flu test to explain his symptoms, they did a painful test for rhinovirus, one of the viruses lumped together as the “common cold”. Again, he was sent home to rest and wait. Our hope was a positive rhinovirus test – once we have a diagnosis we can follow a treatment plan, rather than bouncing back and forth to the ER.
Over this weekend, with Wes still hovering around the fever threshold and dreading an admission, we got ahold of the on-call oncologist. She very gently told me she knows we were hoping he was rhinovirus-positive, and that she didn’t want me to be alarmed but they did have a positive test result, but it was for a different virus, the common and far less scary strain of one that had been in the news a lot lately: coronavirus.
She quickly told me what I had only just learned that week – that mainstream coronavirus is another of the “common cold” viruses, and this is the strain Wes has. This was good news, in spite of the alarm it caused briefly in all of us. He has a cold virus. We can deal with that. She asked us to call immediately if we were alarmed by any new developments, but otherwise we can let him rest at home.
After weeks of high alert, this was a strange relief. Still, it wasn’t over. He has had strangely fluctuating temperatures – oftentimes a high temp will be gone by the time we check him again a few moments later. With three thermometers in rotation, we have ruled out equipment problems, so all we can do is watch the rollercoaster and hope it doesn’t get so high, or low, as to be dangerous.
Last night his temperature dropped below normal range for the first time – he’d been trending hot if anything – and he also was showing other troubling signs. Pale, clammy, and lethargic with a low temperature, as well as moody, our best guess was a bout of hypoglycemia on top of everything else. He passed out at 6 in bed after a tantrum had brought him upstairs for a timeout, so we let him rest while we strategized. While he had eaten quite well yesterday, it still looked like low blood sugar, so I woke him up at 7 for a snack. He ate a piece of chocolate, and then wanted to come downstairs with me, so we went down and he ate more. Still, while food perked him up a little, it didn’t have the reaction I hoped for – he was still showing most of the same symptoms.
I brought him back up to bed, and his temperature was low enough to be concerned, but not critical, so we decided to monitor him – if his temp went down much more we’d have to get him to the ER, but instead he stayed stable. An hour or two later, I went to bed with him and checked him throughout the night.
This morning we called oncology again and asked if we could bring him in for a checkup. Setting aside hypoglycemia, which didn’t seem to be the case, the best guess is he needs a transfusion. His hemoglobin was low, but not low enough to need a transfusion, on Friday, so maybe it’s time now.
This is life for Wes – and the other three of us – with a “common cold”. Even when it’s not life-threatening, even when we don’t get admitted, it’s incredibly hard on all of us. It disrupts any plans we might have, keeps us in isolation, throws me off my work. It’s exhausting and stressful, and it can go on for weeks or more.
So please – if you’re sick, stay home. Don’t go out in public, and if you have to, practice decency and good hygiene – wear a mask, wash your hands, and keep your distance – because chances are you’ll recover a lot faster than Wes will.
